A Breast-Feeding Inspiration: One Mother’s Extraordinary Commitment

When Kira Grace was born on December 2, 2008, her mother, Chrisamy, never considered not breast-feeding her. Little did Chrisamy know at delivery what the commitment to breast-feeding might entail and what her dedication to feeding breast milk to her baby might demand of her.

Chrisamy had successfully breast-fed her son Chad, now 4 years old, after overcoming the initial challenges of poor latching, sore/cracked/bleeding nipples, and plugged milk ducts. In addition, Chad had gastroesophageal reflux (GER) and a hyperactive nervous system, and he cried inconsolably for hours on end. Despite all these problems, Chrisamy successfully breast-fed Chad until he was 1 year old. Even with this previous experience, she knew that she would breast-feed her second baby, with the hope that the second time would be easier. After all, what could possibly be more challenging than her experience with Chad? What else could go wrong?

Moments after birth, Kira took to the breast amazingly well, with a strong rooting and sucking reflex. Chrisamy’s milk supply was more than adequate for a good-natured baby with a healthy appetite for her milk. During her first week of life, Kira appeared to be doing well, with some minor choking episodes during feedings. As these episodes increased, it became apparent that Kira was in distress, and feedings became more stressful for both infant and mother. A trip to the pediatrician resulted in a diagnosis of GER. Medication was started to alleviate the choking. It did not. The pediatrician quickly referred Chrisamy to a pediatric gastroenterologist, which prompted an upper GI test. During this test, the barium that was to flow to the stomach did not; instead, it was found to be flowing into the lungs. Kira was immediately admitted to a local children’s hospital and was scheduled for a bronchoscopy to evaluate a possible abnormality in her throat. A pediatric ENT specialist conducted the procedure and made a diagnosis of a laryngeal cleft (a small opening between the larynx and the esophagus). Laryngeal cleft carries a high infant mortality rate because this condition is frequently not discovered until life-threatening events occur. Everyone appreciated the pediatrician’s speedy referral, which facilitated early intervention before disaster struck.

Kira was hospitalized for 5 days to monitor her status and to make sure all systems were working. The only way to feed her until the cleft could be surgically repaired was with a nasogastric feeding tube. This tiny tube inserted through the nose and extending to her stomach was now her new lifeline. At this point, Kira needed to be fed every 3 hours around the clock so she could regain the weight she had lost during her first 2 weeks of life. Chrisamy stayed with her baby around the clock, pumping her breast milk and then infusing it into the baby via the feeding tube powered by another powerful pump.

Kira was discharged to home with the feeding tube and pump, which would remain with her until her corrective surgery on February 25, 2009. Surgery could not take place until the GER was controlled and the stomach acid studies showed that the surgeon could safely operate on her. A daily/nightly routine for mom and baby required Chrisamy to pump both breasts—a 20-minute endeavor—every 3 hours around the clock. During this time period, nothing else could be done because Chrisamy needed both hands to hold all the equipment. Fifteen minutes before three of the daily feedings, medication was administered through the feeding tube. The breast milk was then poured into a bag attached to the pump and the feeding tube where the milk was titrated and infused in the correct amount. Kira’s feeding would last another 45 minutes to 1 hour plus cleanup time for all the pumps, tubes, milk bags, and medication syringes after every feeding. Life revolved around pumping breast milk and feeding the baby. Little time was left for even the simplest activities such as bathing, eating, and sleeping.

As all breast-feeding mothers know, the milk supply goes down or stops if the mother is tired (who would not be tired with this schedule?) sick, stressed, poorly hydrated, or poorly nourished. Chrisamy could claim the first three items on this list. Even so, keeping the milk supply adequate was a challenge. At times, she added the herb Fenugreek, as well as Mother’s Milk Tea, to her daily routine to boost her milk supply. Cabbage leaves applied to the breast gave relief for milk ducts that became hard and tender. Fatigue and worry were two of the biggest issues. Fatigue from ‘round-the-clock multi-hour feedings, raising a 4-year-old child, caring for three large dogs, running a household, and having a husband who worked away from home for days at a time multiplied the exhaustion and stress.
Compounding health issues for Kira included an atrial septal defect (ASD), a small hole in the heart that may close without surgical repair. She was born with one extra digit on her left hand and was sent for genetic screening to rule out potential genetic syndromes. These test results were normal; the family had to wait nearly 3.5 months to receive the welcome news.

Many people wondered why a mother facing all these challenges would continue to pump her breast milk to feed her infant rather than simply opening a can of formula and pouring it into the feeding pump. After all, baby formula is nutritious, right? Chrisamy believed in the short-term and the long-lasting health benefits that children and their mothers gain from breast-feeding. Her dedication was exceptional under the circumstances. Many moms would have stopped breast-feeding early on. But she never lost the desire and hope that when the feeding tube was removed, she could resume feeding her baby directly from the breast. Her love for her baby was evident in her persistence in light of the obstacles.

Readers may wonder how baby Kira took to the feeding tube. All babies are fascinated with their fingers and mouths; she was no exception. This fascination caused more than one feeding tube to be pulled out until finger mittens were added to her wardrobe. When a feeding tube would come out (usually late at night, sometimes because it was accidentally displaced), a trip to the hospital emergency department (ED) ensued. Then mother and baby needed to wait while the ED located personnel trained in the reinsertion technique. These outings to the ED—about 6 visits in all—took about 4 hours.

Feeding pumps come with instructions and support (or at least they should). Weekends seemed to be the preferred time for the pump to fail (a time when it was almost impossible to locate someone to troubleshoot or bring another pump to the house). Power outages require an even more creative solution, especially when the backup battery does not function. Chrisamy learned that she could use her car cigarette lighter outlet to power the pump. During a rainstorm, mom, baby Kira, 4-year-old brother Chad, and a load of toys and snacks sat in the driveway while Kira had lunch and the workman repaired downed power lines.

The much-anticipated surgical repair at the end of February was a success, although the feeding tube remained in place for 3 more weeks to allow the surgical site to heal. During the entire period the tube was in place, Kira was given a pacifier to suck when she had the desire, as well as during her tube feedings. Her sucking instinct remained strong. When the day arrived for her to be offered the breast, she had a good rooting response, latched on well, and was able to tolerate ever-increasing amounts of breast milk. Now, at 4 months of age, she is totally fed at the breast. Both she and her mother are delighted and are once again sharing the joys and physical skin-to-skin contact that breast-feeding affords.

Everyone faces challenges in life. Our priorities and the choices we make in those times are what give us the opportunity to evaluate and to define what is most important to us. In these times, we find our inner strength and our true capabilities, and we have the greatest potential for personal growth. Chrisamy never swayed from her steadfastness to breast-feed baby Kira, which was a high priority for her. She was fortunate to have a loving and supportive husband, who is also a devoted father. Chad, being a typical, energetic, 4-yearold, needed to learn to share his mother more often than he would have liked. He adores his baby sister and is old enough to be helpful. He is also learning a most useful life skill: patience. Friends and family helped with meals and some chores and were very much appreciated. But nothing equals the minute-by-minute dedication to continue to breast-feed that Chrisamy made. This dedication is what most inspires me. I am not sure that I could have done what she has done faced with all of the obstacles in her path.

I find her to be a most remarkable woman and one whom I am proud and honored to have known since her birth. She is my only child. Her love and devotion to her children’s welfare is exemplary and has been tested and re-tested every day. Her kindness, patience, and unconditional love are qualities that all mothers aspire to, but often fail to display on a daily basis. Thank you, Chrisamy, for being a shining example to us all. You are truly an inspiration!

Janis L. Frazee is a women’s health nurse practitioner at a reproductive health clinic in Traverse City, Michigan. She is also employed as a part-time medical acupuncturist in a private collaborative practice in Traverse City.